‘I am at peace’
A new interest in an old treatment helped a Michigan woman stay home with her husband during his final months.
Nancy Clary and her husband, Jack, shared a longtime passion for hunting.
They enjoyed time at their cabin in north Michigan. They visited every continent on the globe in search of wild game.
Then life took a turn.
About five years ago, Jack, a retired lawyer and professor at Grand Valley State University, developed vascular dementia.
Later, doctors diagnosed Nancy with stage 4 colon cancer.
Every day in the hospital was a day she’d rather have spent at home with Jack.
“My greatest concern was that I be able to live long enough to take care of him until the end,” Nancy, 81, said.
She started experiencing severe shortness of breath due to an accumulation of fluid around her left lung. Doctors drained her lungs many times, but it kept coming back.
It was a mystery: The fluid didn’t seem to be related to her colon cancer.
That’s when Nancy met Spectrum Health interventional pulmonologist John Egan, MD.
What’s old is new again
Dr. Egan suggested a procedure called pleuroscopy, also known as medical thoracoscopy, to determine the cause of the fluid and permanently relieve Nancy’s shortness of breath.
Pleuroscopy was first used more than 100 years ago as a common treatment for patients with tuberculosis. After anti-tuberculosis medications were developed, doctors in Europe continued to use the procedure to diagnose and treat cancers of the chest, but it fell into relative obscurity in the U.S. until about 20 years ago.
It was recently reintroduced within the Spectrum Health system, and has regained popularity nationally, because it is minimally invasive, safe and accurate.
Pleuroscopy is a technique of inserting a small telescope between the ribs to examine and biopsy the pleural space, which is the area between the chest wall and lungs. At the end of the procedure, a catheter is left in place.
“After we are done, we leave a short drain in, which isn’t connected to anything, so the patient can go about their day and wear normal clothes.” Dr. Egan said. “Then, two or three times a week, a family member will help the patient drain fluid into a bottle.”
Since Nancy had her pleuroscopy in mid-2019, Dr. Egan, along with interventional pulmonologist Gustavo Cumbo-Nacheli, MD, have safely performed more than 70 pleuroscopies. Dr. Egan attributes this success to support from thoracic surgery surgeon Geoffrey Lam, MD, and interventional pulmonology nurse Christine Burkhard, BSN, who helps patients with outpatient care of their pleural drains.
‘An opportunity to fulfill my greatest goal’
The procedure revealed more bad news for Nancy—she had stage 4 breast cancer in addition to her colon cancer.
The good news: She could stay at home instead of the hospital.
Initially, a nurse visited to help with the draining process. But eventually, the nurse taught some family members, including Nancy’s husband, to use the drain.
“Doctor Egan and his staff were wonderful,” Nancy said. “They were so reassuring and they took time to meet with all of my family.”
Nancy used the drain for several months.
In August of the following year, Jack passed away with Nancy lying in bed beside him.
She said the catheter gave them several months together they may not have had otherwise.
“It not only saved my life, but it extended his life, too,” Nancy said. “It allowed me to be able to care for him. He was my life.”
Despite her loss, Nancy embraces the future.
She met her goal of being at her husband’s side when he needed her. And she plans to live the rest of her life to the fullest.
Before retirement, Nancy spent her career in public service as a county manager and a township supervisor. Today she chairs a not-for-profit that provides housing and care for women with addictions.
For a fun diversion and what she calls “egg money,” she sells holiday antiques, an interest she shares with her sister-in-law.
And last fall, she and her granddaughter had a successful deer-hunting excursion.
She’s looking forward to spring.
“If I’m still here in April, I intend go to our cabin up north and harvest another turkey,” she said. “It’s one more thing to look forward to.”
By coincidence, Dr. Egan also hunts turkey, having adopted the sport just a couple of years ago.
“Nancy is more than a patient,” he said. “She’s my turkey-hunting mentor.”
She has even given him a turkey call and helpful advice to improve his odds of success with the wily creatures.
Nancy’s physical activity and time outdoors has kept her at her best, Dr. Egan said.
“My health is as good as can be expected,” Nancy said. “I was privileged to be able to take care of my husband and I did. (The catheter) gave me an opportunity to fulfill my greatest goal.”